Has NWHS helped you in any way?

Checkbox *

Select the following symptoms if you experienced these prior to coming to NWHS (select all that apply):

Stomach ache

Fatigue

Trouble falling asleep

Anxiety

Heart burn

Afternoon energy crashes

Trouble staying asleep

Mood swings

Nausea

Reduced energy

Not feeling rested

Inflammation

Gas

Cravings

Acne

Chronic disease

Bloating

Need for caffeine

Dry skin

Aches/pains

Diarrhea

Constantly hungry

Itchy skin

Headaches/migraines

Constipation

Weight gain

Depression

Other

What services did you use to alleviate these symptoms? *

Check all that apply.

Nutrition Coaching

Nutrition Response Testing

Microcurrent

Name *

First Name

Last Name

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Anonymous